They’re Called ‘Critical Access Hospitals’ for a Reason

From HealthLeaders Media:

For the past couple of years, reports from the Office of the Inspector General at the Department of Health and Human Services have made it clear that they believe the CAH designation and funding scheme should be overhauled.

In its latest shot across the bow, OIG this week called for a re-examination of the swing bed program that allows CAHs to provide long-term care. The OIG audit claimed that the federal government has overpaid CAHs $4.1 billion over the past six years for services that could have cost less in relatively nearby skilled nursing and long-term care facilities.

Rural healthcare advocates rallied around the reply to the OIG recommendations from former Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, who challenged the OIG findings and recommendations in her formal response, and suggested that auditors don’t understand healthcare delivery in rural areas

Telemedicine Is A Game-Changer For Patients, The System

From Forbes:

For many, new health insurance is not providing access to affordable care, and the ACA will not address the physician shortage. To bridge that gap, we must find innovative ways facilitate hassle free access to a provider that is more cost-effective. Telemedicine is a growing model that is a part of the answer.

Telemedicine, or “telehealth,” is the provision of remote access to a physician via phone or videoconference to address a health care issue. It’s not a new concept. It’s well-established in rural areas for specialty consultations, and has been widely used in many primary care practices like pediatrics as a practical matter (although most pediatricians do not bill for phone consultations).

More about that doctor shortage, er, poor distribution of physicians

From the Post:

I tried to point out in this post Tuesday that critics of doctor shortage projections have argued for years that the problem is actually poor distribution of physicians, with too many clustered in urban and affluent areas and too few in poor and rural areas. There were 767,000 practicing doctors in the United States in 2013, and some believe that would be plenty if we had them in the right places and in fields that matched the needs of patients.

But a couple of readers said I should do more to present this side, so here you go.

Hospital admissions for chest pain may result from poor communication

From Reuters:

Poor communication may lead some patients with chest pain to be admitted to the hospital even when their risk for a heart attack is low, a small study suggests.

“Ideally, you want the conversation between a physician and a patient to be as straightforward as possible, but in our study of admissions for cardiac observation, we found the risks of going home were terribly overinflated and so was the potential benefit of staying overnight in the hospital,” said lead study author Dr. David Newman.

Telemedicine a safe, affordable solution

From the Journal:

Health reform and the expansion of health care coverage for millions of Americans has dominated the news for several years now. What’s been lost in all the reporting is the reality that, for hundreds of thousands of Americans, having health care coverage helps only if they have access to a physician.

For people who live in states with large rural populations, such as New Mexico, the nearest medical specialist may be hundreds of miles away. This dangerous distance leads to delayed diagnoses and treatment for preventable and treatable conditions.

How then are the needs of rural Americans being served in the new health care system? The emerging answer for many is telemedicine.

Virtual Visit Program

From Four States Homepage:

Making a trip to the doctors office can be hassle when you’re sick.

“I think a lot of times when people have emergency room visits they come into the E.R. and we have to prioritize between the people that are sicker and the people that may be able to wait a few extra minutes, or moments to get seen,” said Dr. Alex Farahmand, INTEGRIS Baptist Regional Hospital.
INTEGRIS Hospital is now offering a new “virtual visit” system for diagnosing patients via the internet. By using a smart phone, computer, or iPad, patients can receive health care right away.

Telemedicine robot benefits stroke patients

From KOTA:

With Stroke being the 4th leading cause of death in the U.S., Regional West Medical Center’s Emergency Department is expanding their stroke capabilities by introducing an onsite telemedicine robot.

The program known as the Collaborative Digital Online Consultant, is a mobile robot with high powered cameras allowing instant access to Denver–based physicians.

These doctors can then consult with patients who show signs of a stroke or other neurological conditions.

Antelope Valley Hospital: ED did not shut down following EHR outage

From Becker’s:

Last week, the National Nurses United and California Nurses’ Association reported Antelope Valley Hospital in Lancaster, Calif., shut down its emergency department Feb. 27 after the EHR and data system failed. However, a hospital statement provided to Becker’s Hospital Review said that these allegations are false.

According to the statement, the hospital did experience a “rare information system outage,” but was able to “quickly identify the problem and immediately took steps to restore our computer systems.”

Additionally, the hospital’s ED did not close. “The emergency department continued to treat patients, logging more than 900 patients over the weekend. At times during the outage, certain patients were diverted to other nearby facilities based on their treatment needs.”

The hospital promptly activated its “downtime procedures” while simultaneously working to address the system malfunction. This is contrary to claims made by the NNU/CAN, which alleged the hospital did not have backup procedures in place.

Emergency doctor dies during duty

From Emirates 24/7:

A Saudi emergency doctor handling an urgent medical case collapsed and died after suffering from a heart attack, a newspaper in the Gulf kingdom said on Tuesday.

Dr Najah Al Qadi was rushed into the cardiac section in the hospital in the Southern Saudi town of Samita but doctors failed to save his life.